影像组学在局限期小细胞肺癌脑预防照射优化中的价值

doi:10.3760/cma.j.cn113030-20220507-00161

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Abstract Objective To investigate the predictive value of enhanced CT-based radiomics for brain metastasis (BM) and selective use of prophylactic cranial irradiation (PCI) in limited-stage small cell lung cancer (LS-SCLC). Methods Clinical data of 97 patients diagnosed with LS-SCLC confirmed by pathological and imaging examination in Shanxi Provincial Cancer Hospital from January 2012 to December 2018 were retrospectively analyzed. The least absolute shrinkage and selection operator (LASSO) Cox and Spearman correlation tests were used to select the radiomics features significantly associated with the incidence of BM and calculate the radiomics score. The calibration curve, the area under the receiver operating characteristic (ROC) curve (AUC), 5-fold cross-validation, decision curve analysis (DCA), and integrated Brier score (IBS) were employed to evaluate the predictive power and clinical benefits of the radiomics score. Kaplan-Meier method and log-rank test were adopted to draw survival curves and assess differences between two groups. Results A total of 1272 radiomics features were extracted from enhanced CT. After the LASSO Cox regression and Spearman correlation tests, 8 radiomics features associated with the incidence of BM were used to calculate the radiomics score. The AUCs of radiomics scores to predict 1-year and 2-year BM were 0.845 (95%CI=0.746-0.943) and 0.878 (95%CI=0.774-0.983), respectively. The 5-fold cross validation, calibration curve, DCA and IBS also demonstrated that the radiomics model yielded good predictive performance and net clinical benefit. Patients were divided into the high-risk and low-risk cohorts based on the radiomics score. For patients at high risk, the 1-year and 2-year cumulative incidence rates of BM were 0% and 18.2% in the PCI group, and 61.8% and 75.4% in the non-PCI group, respectively (P<0.001). In the PCI group, the 1-year and 2-year overall survival rates were 92.9% and 78.6%, and 85.3% and 36.8% in the non-PCI group, respectively (P=0.023). For patients at low risk, the 1-year and 2-year cumulative incidence rates of BM were 0% and 0% in the PCI group, and 10.0% and 20.2% in the non-PCI group, respectively (P=0.062). In the PCI group, the 1-year and 2-year overall survival rates were 100% and 77.0%, and 96.7% and 79.3% in the non-PCI group, respectively (P=0.670). Conclusion The radiomics model based on enhanced CT images yields excellent performance for predicting BM and individualized PCI.

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	Hou Qing
	Wei Lijuan
	Yao Ningning
	Sun Bochen
	Liang Yu
	Cao Xin
	Tan Yan
	Cao Jianzhong

Key words： Small cell lung carcinoma, limited-stage Neoplasm metastasis, brain Radiomics Prophylactic cranial irradiation

Received: 07 May 2022

Fund:Applied Basic Research Program of Shanxi Province (20210302124598); Fund Program for the Scientific Activities of Selected Returned Overseas Professionals in Shanxi Province (Department of Resource and Social Security of Shanxi Province [2019]1176); Shanxi Scholarship Council of China (Department of Resource and Social Security of Shanxi Province [2022] 210); the Four "Batches" Innovation Project of Invigorating Medical through Science and Technology of Shanxi Province ([2022]37)

Corresponding Authors: Tan Yan, Email: tanyan12345@sina.com; Cao Jianzhong, Email: caolv2000@163.com

Cite this article:

Hou Qing,Wei Lijuan,Yao Ningning et al. The value of radiomics for individualized prophylactic cranial irradiation in limited-stage small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2023, 32(1): 8-14.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20220507-00161 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2023/V32/I1/8

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